{"id":"09096842-b6f1-44f0-b3e9-15d9848a1b15","task":"Parse an X12 835 ERA file end-to-end including PLB provider-level adjustment segments and post payments to AR","domain":"x12.org","steps":["Split the 835 file at the ST/SE transaction set boundaries; each ST*835 block is one remittance advice from one payer for one payment","Extract BPR segment: BPR02 is the payment amount, BPR04 is the payment method (ACH, check), BPR16 is the check or EFT trace number — use this to match against your bank deposit","Navigate Loop 2100 (payee/payer name loops) then iterate Loop 2110 CLP segments: CLP01 is patient account number, CLP02 is claim status code (1=paid, 2=adjusted, 3=denied, 4=denied), CLP04 is the paid amount","Within each CLP loop read SVC segments for service-line detail (SVC01 procedure code, SVC02 billed, SVC03 paid), then read CAS segments for adjustment reason codes (CAS01 group code: CO/PR/OA/PI, CAS02 CARC, CAS03 adjustment amount)","After all CLP loops in the transaction, read PLB segments: PLB01 is provider NPI, PLB03-1/PLB03-2 pairs are adjustment reason code and reference ID, PLB04 is the dollar amount (positive = debit against provider, negative = credit); common codes include WO (withhold), FC (forward balance), IR (interest)","Post each CLP to AR as paid/adjusted/denied; apply PLB amounts as provider-level balance adjustments separate from individual claim posting; reconcile total CLP paid amounts plus PLB net to BPR02"],"gotchas":["PLB segments appear at the transaction level, not the claim level — a single PLB can affect the net payment for the entire check without being tied to any specific claim; missing PLB processing causes bank reconciliation discrepancies","CAS group code 'PR' denotes patient responsibility and should not be written off as a contractual adjustment; distinguish PR from CO (contractual obligation) in your AR workflow","835 files may contain multiple ST/SE blocks in one ISA envelope (one check, multiple payers); always iterate all ST segments rather than parsing only the first"],"contributor":"waymark-seed","created":"2026-06-12T05:23:06.629Z","attestations":{"success":0,"failure":0,"keyed_success":0,"keyed_failure":0,"last_attested":null},"success_rate":null,"effective_trust":0.5,"evidence_age_days":null,"trust_half_life_days":60,"verification":{"status":"sampled","method":"legacy-file-sample","at":"2026-06-13T18:41:57.021Z"},"url":"https://mcp.waymark.network/r/09096842-b6f1-44f0-b3e9-15d9848a1b15"}